Mobile Health Interventions

Summary:The Bright By Three (BB3) non-profit was founded in 1995 to provide a low cost intervention that can reach a large proportion of low-income families with the goal of increasing talking, reading, playing, and praise (TRPP) between caregivers and young children. The BB3 intervention provides evidence-based written materials and an annual visit by a trained community worker to review the materials at home or in a primary care clinic or community setting at 1 and 2 years of age. The original intervention, while based on evidence from other interventions, has never been evaluated in an effectiveness trial, and stakeholders were concerned that its effect may be limited by infrequent contact with caregivers. Since more than 70% of low-income families now have access to internet and mobile technology, use of this technology could increase the intensity of the BB3 intervention without significantly increasing cost.Since 2013, our team has been working with BB3 staff, app developers, and parent advisors to develop and pilot test a mobile technology ‘app’ for caregivers to augment the BB3 intervention.To our knowledge, this type of multi-level intervention to promote early childhood development through increasing caregivers’ TRPP behaviors has not previously been tested.Therefore, we propose to conduct a pilot hybrid trial to study the effectiveness and implementation of the multi-level BB3 intervention among 1 to 2 year old children and their caregivers.

Summary: The objectives for this project are to evaluate a bilingual English-Spanish tailored text messages and online support system to support exclusive and continuous breastfeeding for new mothers--comparing texting alone, texting with an online support group to those with usual care, to determine the cost involved in moderating the online groups and providing bidirectional consultation when needed and to obtain qualitative feedback from a subset of mothers in both intervention groups to determine what was effective, as well as suggestions for improvement of the messaging program.